Stigma as a deterrent to PrEP usage among Black sexual minority men
This recent journal article by Faculty Associates Typhanye Dyer, Hongjie Liu, and collaborators published in SN Social Sciences examines latent profiles of PrEP utilization and racial, sexuality-based, and other stigmas in Black sexual minority men.
Prior work has identified that Black sexual minority men (BSMM) have a relatively low usage of pre-exposure prophylaxis (PrEP) compared to other sexual minority men, despite PrEP being a highly effective method for HIV prevention. Internalized race, sexuality-based stigma, and intersectional stigma may be a driver for HIV disparities among BSMM, in part through deterring PrEP utilization. In the current study, the authors employed a person-centered perspective (i.e., latent profile analysis) to investigate profiles of PrEP stigma, HIV stigma, internalized and anticipated homophobia, internalized and anticipated racism, and PrEP acceptability and usage.
The researchers identified the emergence of three profiles:
- Low Internalized Stigma, High Anticipated Stigma
- High Internalized and Anticipated Stigma
- High Internalized Stigma, Low Anticipated Stigma
Regression analyses found that the High Internalized and Anticipated Stigma profile had PreP usage and acceptability about 3x as low as the Low Internalized Stigma, High Anticipated Stigma profile. Additionally, the High Internalized Stigma, Low Anticipated Stigma profile had PrEP acceptability 3x as low as the Low Internalized Stigma, High Anticipated Stigma profile. These findings highlight the unique impacts of internalized and anticipated stigma, where high internalized stigma may be a greater deterrent to PrEP utilization and acceptability than anticipated stigma. The most stigmatized profile also had the highest depression scores.
The researchers conclude by suggesting that internalized stigma, as well as general mental and emotional wellness, may be important intervention targets for increasing PrEP usage among BSMM.
Turpin, R., Smith, J., Watson, L. et al. Latent profiles of stigma and HIV pre-exposure prophylaxis among Black sexual minority men: an exploratory study. SN Soc Sci 2, 192 (2022). https://doi.org/10.1007/s43545-022-00490-w
